page_title: Phineas Gage
section_title: Later observations (1858–1859)
hierarchical_section_title: Phineas Gage / Mental changes and brain damage / Later observations (1858–1859)
caption_attribution_description: See other version
context_page_description: Phineas P. Gage was an American railroad construction foreman remembered for his improbable survival of an accident in which a large iron rod was driven completely through his head, destroying much of his brain's left frontal lobe, and for that injury's reported effects on his personality and behavior over the remaining 12 years of his life‍—‌effects sufficiently profound that friends saw him as "no longer Gage."
  Long known as the "American Crowbar Case"‍—‌once termed "the case which more than all others is calculated to excite our wonder, impair the value of prognosis, and even to subvert our phys­i­o­log­i­cal doctrines" ‍—‌Phineas Gage influenced 19th-century discussion about the mind and brain, par­tic­u­larly debate on cerebral local­i­za­tion, ​​ and was perhaps the first case to suggest the brain's role in deter­min­ing per­son­al­ity, and that damage to specific parts of the brain might induce specific mental changes.
context_section_description: In 1860, an American physician who had known Gage in Chile in 1858 and 1859 described him as still "engaged in stage driving [and] in the enjoyment of good health, with no impairment whatever of his mental faculties". Together with the fact that Gage was hired by his employer in advance, in New England, to become part of the new coaching enterprise in Chile, this implies that Gage's most serious mental changes had been temporary, so that the "fitful, irreverent ... capricious and vacillating" Gage described by Harlow immediately after the accident became, over time, far more functional and socially far better adapted.
  Macmillan writes that this conclusion is reinforced by the responsibilities and challenges associated with stagecoach work such as that done by Gage in Chile, including the requirement that drivers "be reliable, resourceful, and possess great endurance. But above all, they had to have the kind of personality that enabled them to get on well with their passengers." ​​ A day's work for Gage meant "a 13-hour journey over 100 miles [160 km] of poor roads, often in times of political instability or frank revolution. All this‍—‌in a land to whose language and customs Phineas arrived an utter stranger‍—‌militates as much against permanent disinhibition [i.e. an inability to plan and self-regulate] as do the extremely complex sensory-motor and cognitive skills required of a coach driver." ​​ (An American visitor wrote: "The departure of the coach was always a great event at Valparaiso‍—‌a crowd of ever-astonished Chilenos assembling every day to witness the phenomenon of one man driving six horses.")
caption: "Please deliver my iron bar to the bearer". While in Chile, Gage had his relative B. R. Sweetland retrieve the tamping iron from Harvard's Warren Anatomical Museum.[note 13]
exif: {"Image SubfileType": "Full-resolution Image", "Image ImageWidth": "3644", "Image ImageLength": "1991", "Image BitsPerSample": "[8, 8, 8]", "Image Compression": "Uncompressed", "Image PhotometricInterpretation": "2", "Image StripOffsets": "240", "Image SamplesPerPixel": "3", "Image RowsPerStrip": "1991", "Image StripByteCounts": "21765612", "Image MinSampleValue": "0", "Image MaxSampleValue": "255", "Image PlanarConfiguration": "1", "Image PageNumber": "[188, 0]"}